Musculoskeletal: Hip Special Tests Flashcards
Log Roll Test
Why: Assess for hip pathology without stressing extra articular structures.
How: Patient lies supine with leg fully extended. Therapist passively internally and external rotates leg.
Positive Test: Pain, clicking, with IR or ER, iliofemoral or capsule laxity if excessive ER
Scour Test
Why: To assess inner and outer joint surface for pathology.
How: Patient is supine. Clinician moves leg into flexion at hip and knee. Therapist then moves leg into Abduction and Adduction with IR/ER and axial load into joint articular surfaces.
Positive Test: Hip pain, clicking crepitus
Patrick’s FABER Test
Why: Differentiate between sources of hip pain.
How: Patient supine. Clinician passively flexes abducts and externally rotates leg. Clinician then provides downward force at the knee.
Positive Test:
Inguinal=Hip Joint
Greater Trochanter=Capsular
SI pain=SI joint
FADDIR Test
Why: To assess for Femoral acetabular impingement.
How: Patient is supine. Clinician passively flexes, adducts and internally rotates the hip.
Positive Test: Hip pain or clicking
Posterior Impingement Test
Why: To assess for posterior, inferior labrum impingement.
How: Patient is supine with effected leg near edge of table. Clinician passively brings the leg off the table into extension, abduction, and external rotation. Clinician then provides a passive over pressure to the hip extension.
Positive Test: Hip pain in posterior hip
Craig Test
Why: To assess for femoral ante-rversion or femoral retroversion.
How: Patient is prone on table. Clinician passively flexes the knee on the side to be tested to 90 degrees. Clinician then stabilizes the pelvis and palpates the greater trochanter on the side to be tested. The clinician then passively moves the hip through internal and external rotation via the lower leg feeling for the point in which there is the greatest prominence of the greater trochanter. Once this position is found the clinician measures the angle between the the Femur and the Tibia.
Positive Test: The angle at which the greater trochanter us felt the most.
- Normal=8-15 degrees
- Retroversion=<8 degrees
- Anteverted=>15 degrees
Resisted Hip Abduction
Why: To assess for femoral stress fracture or SI pain.
How: Patient is supine. Clinician abducted leg to be tested to 30 degrees. Clinician then stabilizes opposite side and provides an adduction force to the leg that the patient resists.
Positive Test: Pain at the greater trochanter of the leg that is being abducted=stress fracture.
Pain in the SI=SI joint dysfunction.
Fulcrum Test
Why: To assess for femoral stress fracture.
How: Patient sits on the edge of the table with legs dangling off edge at the knee. Clinican places their forearm underneath the patients femur on the suspected side and stabilizes the other femur with the hand. The clinician then performs a downward force distal to the forearm at the patients knee using the forearm as a fulcrum. Clinician can move the forum more proximal or distal.
Positive Test: Pain in the femur. Typically the shaft of the femur.
Percussion Patella Test
Why: To assess for femoral stress fracture or hip fracture.
How: Patient is supine with legs extended. Clinician laces one end of a stethoscope on the pubic tubercle on the side to be tested. The clinician then taps the patella with the other hand and listens for the sound in the stethoscope.
Positive Test: The clinician should hear a sharp sound in the stethoscope indicating the femur and hip are intact. If the clinician here’s a dull sound this may be indicative of a stress fracture to the femur or or hip fracture.
Supine Plank Test
Why: To assess for hamstring weakness.
How: Clinician has the patient perform a plank. The clinician then has the patient elevate one leg on the side opposite the suspected weak hamstring.
Positive Test: The inability to maintain the plank position when elevating the leg.
Thomas Test
Why: To assess for flexibility to one and two joint hip flexors.
How: Patient sits on the edge of the table with legs dangling off at the knee. Clinician has the patient grasp the knee of the side opposite to be tested and has them bring it to the chest. The clinic then guides the patient into supine and observes for several signs.
Positive Test:
Clinician observes for excessive lumbar lordosis which may indicate tight hip flexors. Clinician observes for the position of the femur relative to the table. If the femur and thigh are not able to come in contact with the table this may be indicative of tightness to the hip flexors. The clinican then observes the position of the knee joint for determining the difference between one and two joint hip flexor tightness.
If the knee is extended greater than 80 degrees this is indicative of Rectus Femoris (two joint hip flexor) tightness. If the thigh is not in contact with the table but the knee can flex to beyond 80 degrees this would be indicative of posts tightness (single joint hip flexors.)
Ely’s Test
Why: To assess for Rectus Femoris Flexibility
How: Patient is prone. Clinician passively moves the patient into knee flexion.
Positive Test: Patients hip raises off the table indicating tightness of rectus femoris (Two joint hip flexors).
Ober’s Test
Why: Assess IT band/TFL mobility.
How: Patient is sidelying with lower hip and knee flexed for stability. Clinician passively moves upper leg into extension abduction with knee flexed to 90. Clinician then allows hip to drop down and observes for the legs ability to drop below anatomic neutral.
Positive Test: Patient’s leg is unable to drop below anatomic neutral indicating tightness of the ITband/TFL.
Modified Ober’s Test
- Same as Ober’s but with knee straight.
Straight Leg Raise Test
Why: To assess Hamstring flexibility/mobility.
How: Patient is supine with legs extended. Clinician performs a straight leg raise by moving the leg through hip flexion with the knee extended.
Positive Test: The patient has pain in the back or posterior leg or resistance to hip flexion.
